Chapter 07: Cultural Diversity in the Community Nursing School Test Banks

Stanhope: Public Health Nursing, 8th Edition

Chapter 07: Cultural Diversity in the Community

Test Bank

MULTIPLE CHOICE

1. Which statement about the nursing workforce is true?
a. The nursing workforce is overwhelmingly Caucasian.
b. The number of minority nurses meets the needs of the countrys demographics.
c. The nursing workforce has many unauthorized immigrants.
d. Refugees make up a large part of the nursing workforce in some areas.
ANS: A
The nursing work force is 81.8% Caucasian. The other statements are false.

DIF: COG: Understanding REF: 142 OBJ: 1

2. The 1986 Immigration Reform and Control Act had what effect on illegal aliens living in the United States?
a. Discriminated against individuals from Southern and Eastern Europe
b. Allowed illegal aliens already living in the United States to apply for legal status
c. Permitted foreign-born populations to set up communities in or around major metropolitan areas
d. Allowed illegal aliens access to green cards that would allow them to work in the United States
ANS: B
The 1986 Immigration Reform and Control Act permitted illegal aliens already living in the United States an opportunity to apply for legal status if they met certain requirements.

DIF: COG: Understanding REF: 142 OBJ: 1

3. A large portion of foreign-born residents of the United States:
a. Work in service-producing and blue-collar sectors
b. Reside in rural areas
c. Have language barriers
d. Are refugees and non-immigrants
ANS: A
Two thirds of the foreign-born population lives in or around major metropolitan areas and works in mainly service-producing and blue-collar sectors. They are also more likely to be poorer. The majority of foreign born are legal immigrants (85%).

DIF: COG: Understanding REF: 143 OBJ: 1

4. Which statement about race is true?
a. In the United States, children of biracial parents are usually assigned the race of the father.
b. Ethnicity and race are synonymous terms.
c. Individuals may be of the same race but of different cultures.
d. No social significance is usually placed on race.
ANS: C
It is often a misconception that persons of the same race have the same culture. For example, African Americans may have been born in Africa, the Caribbean, North America, or elsewhere and have very different cultures.

6. An example of an explicit cultural behavior is:
a. Verbal communication
b. Body language
c. Use of titles
d. Perception of health and illness
ANS: A
Explicit behaviors are straightforward and do not leave room for misinterpretation of what the person wants to communicate, such as when using verbal communication. Implicit behaviors are less exact and may be difficult to interpret, including body language, use of titles, and perception of health and illness.

DIF: COG: Applying REF: 144 OBJ: 1

7. A 35-year-old man from Russia comes to the United States seeking asylum because of religious persecution in his native country. This type of immigrant is known as a(n):
a. Legal immigrant
b. Lawful permanent resident
c. Refugee
d. Unauthorized immigrant
ANS: C
Refugees are people who seek protection in the United States because of fear of persecution in their homeland.

DIF: COG: Applying REF: 143 OBJ: 1

8. A visitor from Japan comes to the United States for a two-week vacation. This person is known as a:
a. Non-immigrant
b. Refugee
c. Legal immigrant
d. Lawful permanent resident
ANS: A
A non-immigrant is admitted for a limited duration for a specific purpose.

DIF: COG: Applying REF: 143 OBJ: 1

9. An example of a behavior that may be defined by culture is:
a. Speaking a dialect of a language in a local region
b. Standing when an older adult gets on the bus to give him a seat
c. Immigrating to the United States seeking work
d. An organizational structure of a cultural group
ANS: B
Behaviors may be culturally determined as illustrated in the correct response. This behavior is based on the value of respect of elderly people.

DIF: COG: Analyzing REF: 144 OBJ: 1

10. Nurses who strive to be culturally competent should:
a. Respect individuals from different cultures and value diversity.
b. Immerse themselves in different cultures.
c. Design care for special ethnic groups.
d. Give explicit instructions to avoid client decision making.
ANS: A
Nurses who strive to be culturally competent respect individuals from different cultures and value diversity. The other answers are false.

DIF: COG: Applying REF: 146 OBJ: 2

11. To meet a clients needs, it is sometimes necessary to integrate into the clients care a culturally relevant practice that lacks scientific utility. This is known as cultural:
a. Accommodation
b. Brokering
c. Preservation
d. Repatterning
ANS: A
Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help people of a particular culture to accept nursing strategies, or to negotiate with nurses to achieve satisfying health care outcomes.

DIF: COG: Applying REF: 151 OBJ: 2

12. An example of a cultural encounter is:
a. Sharing significant assessment findings with members of a racial minority
b. Visiting the native land of the clients served at a community health center
c. Telephoning the priest at a Latino church to discuss the health issues of a client
d. Learning about traditional healing practices from an American Indian client
ANS: D
Learning about traditional healing practices is an example of a direct cultural encounter. This occurs when a nurse engages in cross-cultural interactions.

DIF: COG: Applying REF: 149-150 OBJ: 2

13. A nurse demonstrates cultural desire to provide culturally competent care by:
a. Relying on a textbook for information about an ethnic group
b. Bringing a translator to the local community clinic
c. Taking Spanish classes in the evening at a local college
d. Judging others using his or her own cultural values
ANS: C
The activity that suits the definition of cultural desire is one that a nurse would want to do instead of being directed to do so, referring to the intrinsic motivation of the nurse.

DIF: COG: Applying REF: 150 OBJ: 2

14. A Mexican American mother insists on using special candles to help her daughters ear infection. The nurse asks the mother if she would also give her daughter antibiotics. This is called cultural:
a. Accommodation
b. Repatterning
c. Brokering
d. Awareness
ANS: A
This means that the nurse supports and facilitates the use of cultural practices with interventions from the biomedical health care system. Cultural accommodation refers to assistive, supportive, facilitative or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies, or negotiate with nurses to achieve satisfying health care outcomes.

DIF: COG: Applying REF: 151 OBJ: 2

15. When a nurse supports the use of traditional home remedies in conjunction with Western medicine to promote healthy behaviors, the nurse is using cultural:
a. Accommodation
b. Brokering
c. Preservation
d. Repatterning
ANS: C
Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health.

DIF: COG: Analyzing REF: 151 OBJ: 2

16. A nurse implements nursing interventions considering the uniqueness of the persons culture. The practice is called cultural:
a. Diversity
b. Knowledge
c. Competence
d. Awareness
ANS: C
Providing care based on the uniqueness of the clients cultural norms and values is one of the four guiding principles of culturally competent nursing care.

DIF: COG: Analyzing REF: 146 OBJ: 2

17. An effect of providing care that is not culturally competent is:
a. Enhancement of communication
b. An increase in the cost of health care
c. Achievement of health indicators
d. Improvement in client compliance
ANS: B
Care that is not culturally competent may increase health care costs and decrease positive client outcomes.

DIF: COG: Understanding REF: 146 OBJ: 3

18. The tendency to ignore all differences between cultures and to act as though the differences do not exist is defined as cultural:
a. Conflict
b. Shock
c. Blindness
d. Imposition
ANS: C
Cultural blindness occurs when people state that everyone is treated the same, regardless of their cultural orientation.

DIF: COG: Understanding REF: 154 OBJ: 3

19. Segregation is an example of:
a. Prejudice
b. Cultural imposition
c. Racism
d. Stereotyping
ANS: C
Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior in, for example, intelligence, morals, beauty, and self-worth.

DIF: COG: Applying REF: 152-153 OBJ: 3

20. A nurse believes that the best treatment for illness is the use of Western medicine and alternative therapies should not be used for healing. This is an example of:
a. Ethnocentrism
b. Cultural imposition
c. Racism
d. Stereotyping
ANS: A
Ethnocentrism is the belief that ones own cultural group determines the standards by which another groups behavior is judged.

DIF: COG: Applying REF: 153 OBJ: 3

21. The nurse labels a patient an alcoholic because of his ethnicity. This is called:
a. Stereotyping
b. Prejudice
c. Racism
d. Ethnocentrism
ANS: A
This is an example of ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.

DIF: COG: Applying REF: 152 OBJ: 3

22. A nurse resigns from a position in a hospital to accept a job in a community setting. After starting the new job, the nurse feels helpless and confused, wondering if this was the right career choice. This nurse is likely experiencing cultural:
a. Conflict
b. Relativism
c. Shock
d. Brokering
ANS: C
Culture shock can happen to individuals within their own culture when they are having experiences such as starting a new job or career. Culture shock is brought on by anxiety from losing familiar signs and symbols of social interaction. Feelings associated with culture shock are helplessness, discomfort, and disorientation.

DIF: COG: Analyzing REF: 154 OBJ: 3

23. A client comes into the clinic and tells the nurse he goes to an acupuncturist for pain. The nurse says he should take pain medication instead. This would be called cultural:
a. Conflict
b. Blindness
c. Relativism
d. Imposition
ANS: D
This is an example of cultural impositionthe act of imposing ones cultural beliefs, values, and practices on individuals from another culture.

DIF: COG: Analyzing REF: 154 OBJ: 3

24. A client shares that her grandparents immigrated to the United States from Germany. She has disclosed her:
a. Multiculturalism
b. Ethnicity
c. Race
d. Culture
ANS: B
Ethnicity represents the identifying characteristics of culture, such as race, religion, or natural origin.

DIF: COG: Applying REF: 145 OBJ: 4

25. When working with an immigrant population, the first step the nurse should take is:
a. Be aware of ones own culture.
b. Become familiar with traditional practices of the immigrants.
c. Try to see things from the immigrants viewpoint.
d. Learn to speak the language of the immigrant population.
ANS: A
The first statement is the only one that is correct.

DIF: COG: Applying REF: 144-145 OBJ: 4

26. A nurse wants to obtain information on the alternative methods of health care her 45-year-old female client uses. Who is the best person to ask about this?
a. The husband of the client
b. A community leader of the ethnic group
c. The client herself
d. The religious leader of the ethnic group
ANS: C
Clients provide a rich source of information about their own cultures.

DIF: COG: Analyzing REF: 148 OBJ: 4

27. Hispanics tend to believe that the needs of the family take priority over those of the individual. This is an example of cultural variations of:
a. Communication
b. Space
c. Social organization
d. Environmental control
ANS: C
Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions.

DIF: COG: Applying REF: 158 OBJ: 5

28. In the Vietnamese culture, individuals may focus on wishes and memories of their ancestors and look to them to provide direction for current situations. This is an example of cultural variations of:
a. Communication
b. Space
c. Social organization
d. Time
ANS: D
This is the duration or period between successive events, where some cultures assign greater or lesser emphasis to events that occur in the past, present, or future.

DIF: COG: Applying REF: 158 OBJ: 5

29. Asians may perceive illness as disharmony with other forces and that medicine is only able to relieve the symptoms rather than cure the disease. They may look to naturalistic solutions and acupuncture to resolve or cure health problems. This is an example of cultural variations of:
a. Communication
b. Space
c. Social organization
d. Environmental control
ANS: D
Environmental control refers to the ability of individuals to control nature and to influence factors in the environment that affect them.

DIF: COG: Applying REF: 158 OBJ: 5

30. Research has shown that Asian men tend to have a greater sensitivity than white Europeans to codeine, and they experience significantly weaker effects from the drug. This is an example of cultural variations of:
a. Biological variations
b. Space
c. Social organization
d. Time perception
ANS: A
Biological variations are the physical, biological, and physiological differences that exist between racial groups and distinguish one group from another.

DIF: COG: Applying REF: 158-159 OBJ: 5

31. A nurse advocates and intervenes between the health care system and the clients cultural beliefs on behalf of the client. The nurses action is called cultural:
a. Accommodation
b. Brokering
c. Preservation
d. Repatterning
ANS: B
Culture brokering is advocating, mediating, negotiating, and intervening between the clients culture and the biomedical health care culture on behalf of clients.

DIF: COG: Applying REF: 152 OBJ: 6

MULTIPLE RESPONSE

1. A nurse is planning a refugee outreach clinic at the neighborhood health center. To provide culturally competent care, the nurse should consider that (select all that apply):
a. Their own background, beliefs, and knowledge may be significantly different from those of the people receiving care.
b. Language barriers may interfere with efforts to provide assistance.
c. Certain risk factors may be present for a given population.
d. Certain groups may use non-traditional healing practices.
ANS: A, B, C, D
When working with immigrants it is important to be aware of ones own beliefs, realize that language barriers may exist, that different populations experience different risk factors and illnesses, and that non-traditional healing practices may be used.

DIF: COG: Applying REF: 143-144 OBJ: 1

2. A nurse will be using an interpreter during a client encounter. What considerations should be made by the nurse? Select all that apply.
a. It is appropriate to use family members as interpreters.
b. Written materials should be available in the clients primary language.
c. Observe the interpreters gestures to assure client understanding.
d. The gender, age, and educational level of the interpreter should be evaluated.
ANS: B, D
Family members should be used with caution. The clients gestures and non-verbal messages should be observed to assure understanding. Written materials should be available in the clients primary language. The gender, age, educational level, socioeconomic status, religion, and dialect should all be considered when selecting the proper interpreter.